Patient's family "riders."

[LonghornMedic]

What's the policy regarding relatives of patients riding in the ambulance to the ER with your agency? We let them ride for the most part. Unless they are disruptive to the patient or the crew. Adult patients with adult family ride up front and typically only parents will ride in the back to assist with keeping their kids calm. However, they never ride up front or in the back when responding to the hospital lights and sirens. Too dangerous for the family, they don't need to see any treatments that may traumatize them further and the driver doesn't need the distraction from a hysterical family member while attempting to drive Code 3.

On a light hearted note from the Paramedic Chronicles(check out their other videos, great stuff and I used to work with these guys)-

[YOUTUBE]http://www.youtube.com/watch?v=nK4j8dn0Hrs[/YOUTUBE]

 

[reaper]

Ours is basically identical to yours. Most ride up front, unless parent of small children.

Now, I have let a spouse ride in back, if there's a chance the pt may not survive. Especially elderly. They want to be near them at the end and I have never had one cause any problems in over 20 years.

 

[JPINFV]

I don't think either company I've worked for had an actual policy. I've personally always treated it as a case by case situation taking into account distance, patient status, and the observed family dynamic.

 

[Aidey]

Official policy is that it is the decision of the crew, with the crew being reasonably accomidating.

My partner and I have discussed it and we have our own "policy" that we follow consistently.

One rider only. All riders go up front, unless there are mitigating circumstances. No riders if the lights and sirens are on, or if the pt is unstable enough we may have to turn them on. No riders if PD is involved (assaults etc, that is at their request). No one who is under the influence of anything, or who poses a safety risk.

Because of the up front rule no one who is a biohazard or who is too small for the airbag. If the patient is the caregiver of a child who is too small to ride up front and no one is available to get them our supervisor deals with it. Because of how our seatbelts are, we don't have a good way to secure a car seat safely to anything but they gurney.

 

[SanDiegoEmt7]

+1 For Aidey's policy.

Historically, I've never had issues with riders but there have been issues with people following in their personal vehicle. If we end up upgrading to L&S people usually end up trying to follow us against traffic lights etc. Most of the time I tell people not to try to convoy with us if the patient is anything but stable.

 

[clibb]

If we have a an infant or preschooler in the back we let the parent be there if the patient is stable. When :censored::censored::censored::censored: hits the fan we pull over and parent get in the front if they "over" react to the situation. If older then preschooler, parent sits up front.

 

[lampnyter]

Mostly we have them sit upfront but like everyone else said, if its an infant the parent could sit in the back.

 

[akflightmedic]

Similar to Aidey's policy however we also had another back up plan.

If someone was insistent they should ride and we did not want them to, we simply radioed our BC and requested permission for a rider.

He would firmly deny us the permission to transport a rider and we would stand in earshot so the person requesting could hear it.

**Note** The BC knew the only time we called on the radio was to get a denial because otherwise it is up to us...it is a great plan and it makes your officer the bad guy, especially since he isn't on scene and lessens on scene confrontational attitude as they now know it is out of your hands and you tried.

 

[Pittma]

Hypothetical situation: What if the pt is, say, 18 yo and the parent wants to go with the pt to the hospital. Let's say they are being transported due to an arm fx. What if the kid doesn't want the parent to ride with them, maybe they're embarrassed or they were doing something they shouldn't have and the pt doesn't want the parents to ride. Are there any HIPAA violations if the parent were to insist? What would you do?

 

[Aidey]

If the patient is an adult and doesn't want a rider, we don't take a rider. With an adult you could argue HIPAA violation, but I'm not sure how successful you would be if there is a close-able door/window between the front and back.

 

[reaper]

Once pt is 18. Does not matter what the parents insist. They have no say in it. If the kid wants them to come, then they ride up front. If they do not want them there, then they do not ride!

 

[Shishkabob]

It's crew choice here, but I tend to accommodate most of the time.


For adult patients, I typically let them ride up front (never in back for any reason). However, I have no qualms at denying the ride to them if they are disruptive or it will be a hassle, and have done it before.


For peds, it's case dependent. If it's a small kid and they cry the moment they get put on the stretcher taken from their parents, I'll allow one of them to sit in the back, but only in the captains seat, and always belted in, with the clear directions that if I need to do something they need to just sit still.

If it's an ALS kiddo, parents sit up front as I need the room to work.



If it's an older kid, they sit up front.

 

[JPINFV]

For the "never in back" people, I've had an adult rider save my butt once with a teenage psych patient during an IFT. 15/16 year old, history of schizoaffective disorder who started to turn aggressive. Mom (who was sitting in the airway seat) basically told him in no uncertain terms to calm down and be quiet. The teenager did.

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[NomadicMedic]

I think most of us follow the same guidelines. I've found at most places it's the crew's choice.

However, I've found that in most cases it's easier if I don't take a rider. For any serious ALS IFT, I say no. Between me, a vent, a couple of IV pumps and two EMTs, there's not a lot of room. And in my fire department medic unit, unless it's a kid, we don't take riders as a rule.

We keep copies of directions to all the hospitals we transport to in the front of the rig. If someone wants to go, I hand them a copy of the directions and say, "We'll see you there..."

 

[MrBrown]

They usually sit in the airway seat or up front.

Brown would never deny a family member the opportunity to come to hospital with the patient unless they were an obvious safety threat in which ase they are likely to get a free ride to the cop shop

 

[LonghornMedic]

Hypothetical situation: What if the pt is, say, 18 yo and the parent wants to go with the pt to the hospital. Let's say they are being transported due to an arm fx. What if the kid doesn't want the parent to ride with them, maybe they're embarrassed or they were doing something they shouldn't have and the pt doesn't want the parents to ride. Are there any HIPAA violations if the parent were to insist? What would you do?

Simple. Parent does not go. I would explain that their child is a legal adult and has the right not to share medical information with them. They may not like that answer, but tough :censored::censored::censored::censored:.

 

[Bullets]

POI-whats an airway seat?

Only up front, and rarely at that. no one who isnt EMS or on-duty armed PD in the back ever. I dont need overractive emotional relatives getting in my way. if they are in the front, at least i can close and lock the door and use the silent patient status lights.

 

[Shishkabob]

POI-whats an airway seat?

Airway seat = captains chair = the rear facing seat right behind the head of the stretcher. The one that gives the best access to the airway.

 

[Veneficus]

Back in the truck days I always let people ride unless there was a specific reason not to. (like patient didn't want them) Would take as many people as I had seatbelts for, never once had a problem.

If the patient was CTD I would always ask if somebody wanted to ride in back with them if somebody was available, I just think it is kindness to let their last memories be with somebody they knew, not just my ugly mug. I would hope somebody would do the same for me.

As I have said before, there comes a time when no amount of "medicine" is going to help. I don't think that is something to be afraid of.

 

[TransportJockey]

I'll let parents ride up front (in the back only if it's a very little kiddo). Other than that I rarely let anyone ride, and definately not if we're running code to the hospital or the pt is CTD.

That said, I was allowed to ride airway when my ex-fiance got taken to the trauma center after being hit by a car. That could have been due to the fact that one of the FD medics that rode in with the local transport agency was an instructor of mine.